Table 8.

Congenital heart disease (CHD) in parturient

Condition	Acyanotic	Cyanotic
Examples	Atrial septal defects (ASD), Patent foramen ovale (PFO), Ventricular septal defects (VSD), Patent ductus arteriosus (PDA), Bicuspid aortic valve (BAV), Coarctation of the aorta (CoA), Congenital coronary anomalies	Tetralogy of Fallot (ToF), Congenitally corrected transposition of great arteries (ccTGA), Ebstein's anomaly
Challenges	Pulmonary hypercirculation, long-standing cases may have severe PAH, present with HF or pulmonary edema leading to respiratory failure Severe PAH may lead to shunt reversal (Eisenmenger syndrome) poor prognosis	Inadequate oxygenation, PAH, right ventricular dysfunction, may present with cardiac or respiratory failure
Management	CVP-guided fluid management, inotropic support, early mechanical ventilation	Avoid increase in PVR (hypoxia, hypercarbia, acidosis), mechanical ventilation, infundibular stenosis may worsen with hypovolemia and tachycardia, maintain preload and avoid arrhythmias